Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,792.07 / $5,128.00 / $21,917.86	Facility		$1,792.07	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,283.98 / $1,792.07 / $3,764.22	Professional		$1,283.98	$1,792.07	$3,764.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,634.87 / $9,172.83 / $20,286.13	Facility		$4,634.87	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,961.10 / $3,163.06 / $12,137.40	Professional		$1,961.10	$3,163.06	$12,137.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,740.43	Facility		$883.20	$1,075.31	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,368.43 / $2,505.58 / $4,230.72	Professional		$1,368.43	$2,505.58	$4,230.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,364.35 / $2,661.66 / $3,833.34	Facility		$1,364.35	$2,661.66	$3,833.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,288.20 / $2,573.59 / $3,553.48	Professional		$1,288.20	$2,573.59	$3,553.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $859.28 / $2,725.60	Professional		$157.37	$859.28	$2,725.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,809.20 / $2,535.28 / $2,793.23	Facility		$1,809.20	$2,535.28	$2,793.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,872.70 / $2,961.46	Facility		$986.25	$1,872.70	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,135.44 / $3,059.16 / $3,781.70	Professional		$2,135.44	$3,059.16	$3,781.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,013.44 / $9,167.59 / $17,546.59	Facility		$6,013.44	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,909.91 / $2,711.85 / $3,610.35	Professional		$1,909.91	$2,711.85	$3,610.35
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,575.84 / $2,252.92 / $3,949.15	Professional		$1,575.84	$2,252.92	$3,949.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,152.85 / $1,152.85 / $1,511.87	Professional		$1,152.85	$1,152.85	$1,511.87